CENTENNIAL, Colo. - James Holmes, accused of the cinema attack during a Batman film that killed 12 people and injured 70 others last year, was slated to make a highly anticipated court appearance Tuesday, when he is expected to a plea of not guilty by reason of insanity.

City Desk

Updated: March 12, 2013

James Holmes (L) makes his first court appearance at the Arapahoe County Courthouse with his public defender Tamara Brady on July 23, 2012 in Centennial, Colorado. According to police, Holmes killed 12 people and injured 58 others during a shooting rampage at an opening night screening of "The Dark Knight Rises" July 20, in Aurora, Colorado. (Photo by RJ Sangosti-Pool/Getty Images)

CENTENNIAL, Colo. – James Holmes, accused of the cinema attack during a Batman film that killed 12 people and injured 70 others last year, was slated to make a highly anticipated court appearance Tuesday, when he is expected to a plea of not guilty by reason of insanity.

Holmes’ lawyers have repeatedly raised questions about his mental health, including a recent revelation that he was held in a psychiatric ward for several days last year, often in restraints, because he was considered a danger to himself.

Holmes is charged with 166 counts, mostly murder and attempted murder, in the July 20 assault on moviegoers at a midnight showing of “The Dark Knight Rises” in Aurora, a Denver suburb. The brutal killings were one of a string of public mass killings last year that launched a fierce national debate over gun control.

If, as many expect, Holmes’ lawyers enter an insanity plea on his behalf Tuesday, it will clarify the court battle ahead: Was Holmes, 25, legally insane — unable to tell right from wrong — at the time of the shootings?

Pleading insanity could be the only way he can avoid life in prison or execution, given the evidence that has emerged so far, some legal experts said.

Prosecutors laid out a case that Holmes methodically planned the shooting for months, amassing an arsenal and elaborately booby-trapping his apartment to kill anyone who tried to enter. On the night of the attack, they say, he donned a police-style helmet, gas mask and body armour, tossed a gas canister into the seats and then opened fire.

“This is not a whodunit,” criminal defence attorney Dan Recht said in January. He is not involved in the case.

If a jury agrees Holmes was insane, he would be committed indefinitely to a state mental hospital. There would be a remote and unlikely chance he could be freed one day if doctors find his sanity has been restored.

The plea carries risk, however. Prosecutors would gain access to Holmes’ mental health records, which could help their case if the evidence of insanity is weak. If Holmes does plead insanity, the proceedings would be prolonged further while he is evaluated by state mental health officials.

“You heard the evidence they have. There is no doubt that he knew what he was doing was wrong, there’s no doubt it was premeditated,” said Tom Teves of Phoenix, whose 24-year-old son, Alex, died in the theatre while shielding his girlfriend. “There’s no doubt he did it. Zero. So why are we playing a lot of games?”

Holmes could also plead innocent — not by reason of insanity — which would significantly change the court fight. Prosecutors would not have those medical records, but Holmes could be convicted outright, with a possible life term or death.

No matter how Holmes pleads, he could still be convicted and sentenced to execution or life in prison without parole. Prosecutors have 60 days after the plea to say whether they will seek the death penalty.

The hard-fought case has already taken some surprise turns, and Tuesday’s hearing could offer another unforeseen twist, including the remote possibility the two sides, ordered by the judge to not speak publicly about the case, have reached a plea agreement.

Since his arrest outside the theatre, his attorneys have aggressively challenged prosecutors, investigators and even the constitutionality of Colorado law nearly every step of the way.

Just this month, they asked the presiding judge, William Sylvester, to rule parts of the state insanity law unconstitutional, arguing it raised too many questions for them to give Holmes effective advice. Sylvester refused.

“This is going to take some time. You know, I remind myself that they got the guy, he’s not going anywhere,” said Tom Sullivan, whose 27-year-old son, Alex, died on his birthday at the movie theatre. “I don’t know what kind of shape he’s in right now, but you assume it’s not a pleasant experience what’s going on right now.”

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